For three decades, Tamara Loyer wrestled with the regular demons that haunt so many in the Downtown Eastside: Sex work, drugs, violence, poor health, poverty and homelessness.

All the while, an even bigger battle waged inside her; she was a woman trapped in a man’s body, an imbalance that shaped her life from a young boy growing up on a Quebec military reserve to a tormented transsexual on Vancouver’s streets.

Stalked by real and perceived bigotry, she sought refuge in an anonymous world where sex was sold to strangers and pain was numbed with dope.

Loyer’s goal to complete her physical transition to female was unobtainable. She had no stability to pursue surgery and no home in which to recover.

“It was always in the bottom of my soul that I wanted this to happen. I’m 52, and it seemed fleeting at times,” she said in a recent series of interviews.

“I needed to get off the street. But I was having a hard time finding housing.”

That changed on a cold and rainy October night in 2011, when an outreach worker plucked an injured and despondent Loyer out of an alley and took her to the first social housing building in which she felt safe: one for women only run by Atira Women’s Resource Society.

Although she looked female, she had the body parts of a man, which was challenging at times in an old, modest SRO where residents shared bathrooms.

With support from her nurse practitioner and Atira staff, Loyer waded into the quagmire of government paperwork and assessments to apply for funding for a sex change operation.

Last month, she emerged from a Montreal gender reassignment hospital with a body finally in sync with her brain: in place of a penis and testicles is now a vagina and clitoris.

Loyer’s agony over her birth gender led her descent from a well-educated computer programmer to a homeless person. She now hopes the surgery will give her the confidence to find a home, a job, and a healthier lifestyle.

“My surgery was the end to an ambiguous gender. I couldn’t go forward when I was both,” she said. “If not for surgery, I’d still be in an alley doing nasty things. I didn’t believe I could get there. I wanted to, but I didn’t believe it.”

Eight of 10 Canadian provinces now fund sex reassignment surgery, which is performed in Canada only at a private Montreal hospital.

Dr. Maud Belanger, who operated on Loyer, said as more provinces have started paying for the operation, the number of homeless patients has increased.

“People who are transgender live (with) more rejection, have more problems with drug abuse ... Patients will tell us, if you didn’t do that surgery, they would probably kill themselves. We hear that at least two to three times a week,” Belanger said in a telephone interview.

“When they get surgery they are more functioning in the society and can get better jobs ... because they feel as they should have since they were a kid.”

Loyer’s 30-year slide into homelessness is not uncommon for people grappling with their sexual or gender identities, according to national studies.

Lesbian, gay, bisexual, transgender and transsexual young people make up 25 to 40 per cent of the national youth homeless population, even though they comprise only five to 10 per cent of the general population, says a report by York University professor Stephen Gaetz and other homelessness researchers.

“Sexual minorities (are) over-represented in street youth populations, a result of tension between the youth and his or her family, friends and community,” says the report, The State of Homelessness in Canada 2013.

A second 2013 report penned by Gaetz, Youth Homelessness in Canada, noted: “discrimination against transgender youth on the streets and in the shelter system is rampant: transgender youth face more discrimination than any other youth group.”

A sex change operation may help alleviate this imbalance, but it isn’t easy to obtain for a marginalized person with no permanent address, no regular access to phones or email, no disposable income and no support network.

Nurse practitioner Jennifer Beaveridge, who has expertise in transgender medicine, helped Loyer overcome some of these obstacles.

“When she moved into (housing) she really got settled, and had a permanent address. I think her self esteem increased,” Beaveridge said.

“Everything started to really pull together for her, to start thinking she was ready for this next step.”

Confused and alone

Loyer was born into a traditional French Canadian military family in 1961. Her father was in the air force. Her mother stayed home to raise Loyer and younger sister Paige.

By age nine, she can remember not identifying with her genitals or her male name.

It wasn’t that Loyer wanted to be a girl. She just never related to being a boy — so becoming female was the only other option.

“You need to be able to be something, and female is better than male to me.”

There were few options to explore this taboo subject on a 1960s military base. At age 14, Loyer ran away from home after a relationship-ending fight with her father.

She lived on her own throughout troubled teen years, yet graduated from high school and completed a three-year diploma in computer programming.

In 1984 she moved west to Vancouver where she assumed the name Tamara.

She pursued four more years of post-secondary education, in areas such as accounting, nautical engineering and commercial design, but keeping an office job was difficult, either because she faced discrimination at work or feared she would.

Loyer treated the pain with drugs, eventually becoming a blur of high heels, glittery jewelry and heavy makeup working the streets.

She tried relationships with both men and women, but was never what her partners were looking for: a gay man or a kinky oddity.

Vancouver was emerging at the time as a supportive city to gay and lesbians, but Loyer did not feel connected to that community.

“I don’t identify as being gay. Gay is about who you want to f**k and gender is who I identify as when I look in the mirror.”

Society’s limited view of transsexuals, Loyer recalled, was of drag queens in big wigs and poofy outfits — which seemed to her a parody of the conflict brewing inside her.

By 1989, she was diagnosed with gender dysphoria — a crippling unhappiness with one’s biological gender.

A supportive doctor prescribed her large doses of estrogen, which has resulted in more feminine features: vastly reduced face, chest, arm and leg hair, subtle curves and hips, less body fat and small breasts.

Also in 1989, she inquired about funding for a sex change operation. But her life was too chaotic to pursue this dream.

“I knew the way things were then I would not be able to lead a normal life,” said Loyer.

She contracted hepatitis C, her mental health deteriorated, and she racked up a few drug and soliciting convictions.

Enraged johns often beat her, she added, when they discovered the prostitute they’d hired had the wrong sexual organs.

She encountered strife daily. Although she presented as female, she had to check into rooming houses with the male name on her B.C. disability cheque, and had to show her male ID to police and hospitals.

One of her biggest challenges was public washrooms and change rooms — she wanted use the ones for women, but was occasionally kicked out for having the wrong body parts.

It is common for trans people to face harassment, according to Vancouver Coastal Health’s transgender health program. Studies found 62 per cent experience depression, and 32 per cent have attempted suicide.

Loyer has made a number of suicide attempts despite taking anti-depressants for 25 years. Many friends, she said, have killed themselves.

She continued to research sex reassignment surgery on free computers at the Carnegie Centre, but her focus on the street had to be finding food and making money.

In recent years she has been a regular fixture panhandling downtown, sitting against a parking metre in gender-neutral clothes, hat extended but never asking for “spare change” as she smiled at passersby. Her repeat clients are kind to her, but others are not.

In October 2011, Loyer was attacked while sleeping on a Coal Harbour sidewalk, and was left with a leg in a cast and very little hope.

“I had my house on my back like a turtle. I was working to try to buy my dope to medicate myself out of existence,” she recalled.

A Carnegie Centre outreach worker found her and insisted she seek shelter in an all-women Atira social housing building. “I was really skeptical of it when I went in there, but the staff made a good effort and the residents did too.”

Atira executive director Janice Abbott said her agency supports all women — and has helped about 20 trans women over the years.

There are obvious challenges to a trans woman sharing a bathroom with other female tenants, Abbott added, noting Atira’s clients are merely a microcosm of society with the same range of biases. “So part of our job is to do education and support, and help women build empathy for each other.”

After moving inside, Loyer stopped her sex work and drug use. She reduced her smoking, ate well, lowered her stress levels, and took her estrogen more regularly — all necessary steps to get ready for the onerous gender reassignment operation.

Beaveridge, who works in a community health clinic where most of her patients have links to drug use, sex work, and HIV or Hep C, travelled several years ago to the Montreal hospital where Loyer had her surgery to learn more about treating transgender patients.

Beaveridge helped Loyer get physically and emotionally ready for the surgery, and in mid-2013 wrote a required letter to the Ministry of Health indicating her patient was ready. Then came the final step, a meeting with a ministry assessor to ensure Loyer was psychologically prepared for this irreversible operation.

The charity Hope Air paid for Loyer’s airfare and Beaveridge arranged for the government to cover the $2,000 fee for her post-surgery care in Montreal — additional costs above the $20,000 MSP pays for the procedure.

The operation took place March 26. Doctors removed her male organs and created a vagina (complete with sensation) in a cavity that naturally exists in male bodies.

Loyer woke up ecstatic.

“I thought, ‘I don’t have any of this baggage any more,’” she said. “Everything fits. Everything works.”

She is still in constant pain, which is muted slightly by strong medication, but remains giddy about the results of the operation.

“I feel like a rebirth,” she said. “I just want to be like everybody else and not worry about the unconventional.”

She will now officially change her name and gender on her identification, and finally hopes to forge healthy relationships with friends and lovers.

“I’d like to venture forth. I don’t want to return to what I’m trying to move away from, which is getting off the street.”

First she faces a six-month recovery from this major, invasive surgery and then Loyer hopes to chart a new path for her future.

She has modest goals.

For now, she may return to panhandling to supplement her disability cheques, but hopes once she fully heals to find her own apartment and return to school or find a job such as walking dogs.

“I feel like I got a second chance. It would be a shame to abuse that, after all the time and effort for something I’ve wanted for so long,” she said.

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